Dried blood spot self-sampling at home is a feasible technique for hepatitis C RNA detection

PLoS One. 2020 Apr 14;15(4):e0231385. doi: 10.1371/journal.pone.0231385. eCollection 2020.

Abstract

To facilitate HCV diagnosis, we developed an HCV-RNA testing service, which involved home-sampled dried blood spots (DBS). The main objective of this study was to evaluate the feasibility of self-sampling at home. Furthermore, to optimise the processing of DBS samples for RNA detection, we evaluated two elution buffers: phosphate-buffered saline (PBS) and L6-buffer. 27 HCV-RNA and 12 HIV-1 RNA positive patients were included. Laboratory spotted DBS (LabDBS) were made by a technician from blood samples drawn at inclusion. Patients received a DBS home-sampling kit and were requested to return their self-sampled DBS (ssDBS) by mail. We compared the RNA load of PBS and L6-eluted labDBS, and of L6-eluted ssDBS, L6-eluted labDBS and plasma. LabDBS load measurements were repeated after 7-13 and 14-21 days to evaluate RNA stability. All 39 plasma samples provided quantifiable RNA loads. In 1/39 labDBS sample, RNA could not be detected (plasma HCV load: 2.98 log10 IU/ml). L6-eluted samples gave a 0.7 log10 and 0.6 log10 higher viral load for HCV and HIV-1 respectively, compared to PBS-eluted samples. Strong correlations were found between labDBS and ssDBS HCV RNA (r = 0.833; mean difference 0.3 log10 IU/mL) and HIV-1 RNA results (r = 0.857; mean difference 0.1 log10 copies/mL). Correlations between labDBS and plasma values were high for HCV (r = 0.958) and HIV-1 (r = 0.844). RNA loads in DBS remained stable over 21 days. Our study demonstrates that self-sampling dried blood spots at home is a feasible strategy for the detection of HCV and HIV-1 RNA. This could facilitate one-step diagnostics and treatment monitoring in communities with high HCV prevalence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dried Blood Spot Testing / methods*
  • Hepacivirus / genetics*
  • Hepacivirus / isolation & purification
  • Hepatitis C / diagnosis*
  • Hepatitis C / virology
  • Humans
  • RNA Stability
  • RNA, Viral / blood*
  • RNA, Viral / metabolism
  • Reagent Kits, Diagnostic
  • Specimen Handling
  • Viral Load

Substances

  • RNA, Viral
  • Reagent Kits, Diagnostic

Grants and funding

This study was executed by the MC Free consortium (www.mcfree.nl) for the NoMoreC project (www.nomorec.nl). MC Free is funded by Gilead Sciences Europe, Gilead Sciences Netherlands, AbbVie, Janssen-Cilag, Merck Sharpe & Dohme, Roche Diagnostics Netherlands. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Gilead Sciences provided support in the form of the salary for TP, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of this author are articulated in the ‘author contributions’ section.